HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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Building Permit Application AUG 0 8 7n11117
Planning and Development Services
Building and Code Regulation Division Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 t• Lu ��ounf-
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential -�
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:z gg Q IJ L14 W 4,54 GC=
Legal Description: —7'2 oi�!I G a C Jga l
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
V -�1t IST /h�� IJi�J U G.,o� /r f�'L Y �'LQj�✓ n 1 Y�q�4 �"C>Z .
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit-check a appy:
HVAC II Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator "Roof $- i Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ /d, p a Utilities:]Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name f 01rk,.4 Name: 10 0&4
Address: Company: TREASURE COAST ROOFING
City:Tom, k�i-+ C--, State: Address: 1816 SW BILTMORE STREET
Zip Code: Fax: City: (DS G -L State:FL
Phone No. q O�- s cl 55 Zip Code: 34984 Fax: 772-343-8358
E-Mail: Phone No. 772-370-9770
Fill in fee simple Title Holder on next page( if different E-Mail: TCROOFINGLLC@GMAIL.COM
from the Owner listed above) State or County License: CCC1330653
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 1816 SW BILTMORE STREET Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signatur of Owner/Lesy/Co-n vlor as Agent for Owner Signature of Contractor/ ' nse&Wer
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLCUIE COUNTY OF STLUCIE
The f oing instr ent was cknowledg efore me The f oing instru nt was a knowledged efore me
this day of � 20by this day of 20by
BRIAN J MALONEY BRIAN J MALONEY
Name of personmakin tatement Name of person making statement
Personally Known x O duced Identification Personally Known xroduced Identification
Type of Identification Type of Identification
Produced Produced
71�
sn&
(Signature of Notar24344
State of Florida ) (Signature of No ublic-State of Florida )
Commission No. FF (Seal) Commission No. FF122 a
ROBERT BRUNKE
'«°°'�e' ROBERT BRUNKE .; "� '_ Notary Public-State of Fonda
r; •`=; Notary Public-State of Florida Commission
`:'My Com E ppn��� 1 6972 c! a6� xpires May 12.2022
REVIEWS FRONTfIN�ae°cnJifi� W 2 PLANS VEGETA 9 NeuO IWR .R VE
COUNTER �' REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17